Aspartate aminotransferase alanine aminotransferase ratio predicts cirrhosis in patients with chronic hepatitis C

ABSTRACT

To confirm the usefulness of aspartate aminotransferase - alanine aminotransferase ratio [AST/ ALT ratio] in predicting cirrhosis in patients with chronic hepatitis C. A prospective non interventional study. Combined Military Hospital, Kharian. Fifty Five patients with chronic hepatitis C were included in the study. Groups included were the patients admitted with sign and symptoms of chronic liver disease due to hepatitis C, blood donors found incidently to be Anti - HCV positive and the persons rejected from embassies duet to Anti-HCV postitive serostatins. The sera of the patients were tested for AST and ALT. Liver biopsy of each patient was performed. Histological Activity Index [HAI] of the specimens was scored on the basis of Knodell score. AST/ALT ratio was correlated with the histological stage [i.e. degree of fibrosis], and the histological grade [i.e. inflammatory activity]. The mean AST/ALT ratio in 17 cirrhotic patients [1.11 +/- 0.18] was higher than in 38 noncirrhotic patients [0.72 +/- 0.23; p < 0.05]. A ratio 1 had 97.36% specificity and 93.75% positive predictive value in distinguishing cirrhotic from noncirrhotic patients with 88.23% sensitivity and 94.87% negative predictive value. The ratio correlated positively with histological stage but not with the grade. Two Patients out of 17 cirrhotic patients [12%] had no clinical or biochemical features suggestive of chronic liver disease except for an AST/ ALT ratio more than one. It is concluded that AST/ALT ratio 1 is highly specific for the presence of cirrhosis in patients with chronic hepatitis C. This ratio reflects the fibrosis stage in these patients. This ratio can be considered as a dependable marker of fibrosis in patients with chronic hepatitis C